E-mail this article

Sending your article

When I’m asked what the most challenging part of my
pregnancy was, I say without hesitation: headaches.

A headache didn’t come on often, but when it did, it was so
painful I could barely open my eyes or keep my head up. Any form of light was
so piercing that I’d have to pull the shades down and lay in bed for hours with
my eyes closed.

While I didn’t experience the same intensity of headaches
before pregnancy, I knew that if I had ever gotten one then, an Advil or Motrin
would often do the trick. For pregnant women however, the medicine cabinet can quickly
become a tricky maze of “take this, not that.” That’s because with pregnancy
comes a whole host of restrictions on medications you can take, from certain pain
relievers to antidepressants.

Headaches were the most debilitating part of my pregnancy
and came on strongest during the first and the start of the second trimester. In
general, most pregnant women are told by their physicians that during that
period of their pregnancy they can safely take acetaminophen, or Tylenol, to
treat any pain conditions, including headaches. Physicians tell women that other common pain medications
such as Advil and Motrin, known as nonsteroidal anti-inflammatory drugs (NSAIDs), are off-limits at any point during pregnancy. But should they be?

NSAIDs are an important class of drugs used to treat chronic
conditions like arthritis. According to a study published March 2012 in the
Journal of Obstetrics and Gynecology, as many as 23 percent of women in the
United States report taking NSAIDs such as aspirin, ibuprofen, or naproxen during their
first trimester. Although the medication is listed as a dangerous drug for
pregnant women and their fetuses, mounting evidence suggests it may be safer to
take during the first trimester than we think.

New research published Monday in the Canadian Medical
Association Journal suggests that women who take NSAIDs during their first
trimester to treat pain have no higher risk for miscarriages than women who don’t
take them. The study looked at more than 65,000 women who gave birth between
January 2003 and December 2009 at a hospital in Israel, more than 4,000 of whom
took NSAIDs during their first trimester.

Besides one type of NSAID known as indomethacin,
the researchers found that about 8 percent of the women who had taken NSAIDs
had miscarriages compared to 10 percent among the group of women who did not
take them.

Previous studies have found that taking NSAIDs during the
first trimester hasn't lead to birth defects. Birth defects are one of many reasons why the medication has been contraindicated during pregnancy. After 30 weeks, however, studies have shown a link to both miscarriages and birth defects. There's some evidence however that taking low-dose aspirin is safe and works to prevent certain conditions like preeclampsia, but it's hard to tell what type of woman will benefit, how much women should take and for how long.

Unfortunately, the findings in studies taking a closer look at risk during the first trimester don’t
necessarily prove that it’s safe to take NSAIDs during that period, or even at any point during pregnancy.

Because each woman is different, your physician is the best judgment on what's right for you.

Some women may take NSAIDs regularly before getting pregnant and are looking to continue their use, while others are just looking for a one-time fever reducer or pain reliever. There’s no clear answer for any of these scenarios, and that’s the
problem.

There’s a lot we don't know about how safe certain medications are for pregnant women--even if they are contraindicated--and NSAIDs are just one
example.

In general, it’s difficult to study medication effects
during pregnancy. By scientific standards – and for obvious reasons -- it’s
unethical to give women powerful medication and see how they or their babies will
react to it. In addition, pregnancy is temporary, and pregnant women are typically such
a small group of people who may be taking a certain medication. So with some
medications, companies and research institutions find it may not be worth the
dollars and cents to study. But for women who are told they should stop taking anxiety medication, antidepressants, or pain medication altogether while pregnant when they may not have to, it makes a big difference.

One good resource for medication safety information during pregnancy is the US Food and Drug Administration's pregnancy registries. The registries are part of ongoing studies comparing women who take medications or have vaccines during their pregnancies with those who do not.

So, is Advil or ibuprofen safe to take while pregnant?
Conventional physicians may tell most of us to play it safe and stay away because the
scientific evidence we have so far will tell us that how often it's used matters, and at least during the first
trimester, we still just don’t know.

About the author

Lara Salahi is an award-winning multimedia journalist whose specialty is reporting health and medical stories. She has worked in local, network, and cable television, international print, and documentary film. She
More »